Cost Effectiveness of Mobile Health for Antenatal Care and Facility
                        Births in Nigeria

Bowser, Diana; Shepard, Don; Nandakumar, A; Okunogbe, Adeyemi; Morrill, Tyler; Halasa, Yara A.; Jordan, Monica; Mushi, Farida; Boyce, Carolyn

doi:10.29024/aogh.2364

Cited by 14 publications

(27 citation statements)

References 19 publications

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“… 45 - 48 The role of digital health in extending access to healthcare services was emphasised in 4 of the 5 studies. 45 - 48 4 studies reported on mobile health implementations; 1 was an initiative supporting AIDS care 49 and the other 3 varying aspects of Reproductive, Maternal, Neonatal and Child health (RMNCH). 45 , 47 , 48 The fifth study dealt with costing a hypothetical teleradiology initative.…”

Section: Resultsmentioning

confidence: 99%

“… 45 - 48 4 studies reported on mobile health implementations; 1 was an initiative supporting AIDS care 49 and the other 3 varying aspects of Reproductive, Maternal, Neonatal and Child health (RMNCH). 45 , 47 , 48 The fifth study dealt with costing a hypothetical teleradiology initative. 46 While all but 1 study achieved the JBI criterion of a description of alternatives (JBI2), including comparison between an intervention and a comparator, 46 only 1 study met the more stringent criterion of analysis of intervention alternatives (FCM-DH3).…”

Section: Resultsmentioning

confidence: 99%

“…The investment analyses reported were simple costings 46 , 49 ; 1 break-even analysis, 47 1 CEA 45 and 1 cost-outcome analysis (COA). 48 All 5 papers identified costs.…”

Section: Resultsmentioning

confidence: 99%

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EHealth Investment Appraisal in Africa: A Scoping Review

Broomhead

Mars

Hons

et al. 2021

INQUIRY

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eHealth is an opportunity cost, competing for limited available funds with other health priorities such as clinics, vaccinations, medicines and even salaries. As such, it should be appraised for probable impact prior to allocation of funds. This is especially pertinent as recognition grows for the role of eHealth in attaining Universal Health Coverage. Despite optimism about eHealth’s potential role, in Africa there remain insufficient data and skills for adequate economic appraisals to select optimal investments from numerous competing initiatives. The aim of this review is to identify eHealth investment appraisal approaches and tools that have been used in African countries, describe their characteristics and make recommendations regarding African eHealth investment appraisal in the face of limited data and expertise. Methods: Literature on eHealth investment appraisals conducted in African countries and published between January 1, 2010 and June 30, 2020 was reviewed. Selected papers’ investment appraisal characteristics were assessed using the Joanna Briggs Institute checklist for economic evaluations and a newly developed Five-Case Model for Digital Health (FCM-DH) checklist for investment appraisal. 5 papers met inclusion criteria. Their assessments revealed important appraisal gaps. In particular, none of the papers addressed risk exposure, affordability, adjustment for optimism bias, clear delivery milestones, practical plans for implementation, change management or procurement, and only 1 paper described plans for building partnerships. Discussion: Using this insight, an extended 5-Case Model is proposed as the foundation of an African eHealth investment appraisal framework. This, combined with building local eHealth appraisal capabilities, may promote optimal eHealth investment decisions, strengthen implementations and improve the number and quality of related publications.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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EHealth Investment Appraisal in Africa: A Scoping Review

Broomhead

Mars

Hons

et al. 2021

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“…In addition, a previous study has suggested that home-based therapy can be as effective as office-based therapy if a biofeedback system is applied [ 70 ]. In addition to increasing training accuracy, the home-based mHealth training app may enable the participants to attend various training programs (eg, the 8-week program adopted in this study) without the burden of visiting clinics as frequently or the need to pay extra costs [ 71 , 72 ]. Thus, the time- and cost-effectiveness of mHealth programs with tongue-strengthening exercises may represent strong points for promoting their widespread use.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Home-Based mHealth App Intervention Program With Human Mediation for Swallowing Tongue Pressure Strengthening Exercises in Older Adults: Longitudinal Observational Study

Kim¹,

Cho²,

Kim³

et al. 2020

JMIR Mhealth Uhealth

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Background Tongue pressure is an effective index of swallowing function, and it decreases with aging and disease progression. Previous research has shown beneficial effects of swallowing exercises combined with myofunctional tongue-strengthening therapy on tongue function. Tongue exercises delivered through mobile health (mHealth) technologies have the potential to advance health care in the digital age to be more efficient for people with limited resources, especially older adults. Objective The purpose of this study is to explore the immediate and long-term maintenance effects of an 8-week home-based mHealth app intervention with biweekly (ie, every 2 weeks) human mediation aimed at improving the swallowing tongue pressure in older adults. Methods We developed an mHealth app intervention that was used for 8 weeks (3 times/day, 5 days/week, for a total of 120 sessions) by 11 community-dwelling older adults (10 women; mean age 75.7 years) who complained of swallowing difficulties. The app included a swallowing monitoring and intervention protocol with 3 therapy maneuvers: effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation. The 8-week intervention was mediated by biweekly face-to-face meetings to monitor each participant’s progress and ability to implement the training sessions according to the given protocol. Preintervention and postintervention isometric and swallowing tongue pressures were measured using the Iowa Oral Performance Instrument. We also investigated the maintenance effects of the intervention on swallowing tongue pressure at 12 weeks postintervention. Results Of the 11 participants, 8 adhered to the home-based 8-week app therapy program with the optimal intervention dosage. At the main trial end point (ie, 8 weeks) of the intervention program, the participants demonstrated a significant increase in swallowing tongue pressure (median 17.5 kPa before the intervention and 26.5 kPa after the intervention; P=.046). However, long-term maintenance effects of the training program on swallowing tongue pressure at 12 weeks postintervention were not observed. Conclusions Swallowing tongue pressure is known to be closely related to dysphagia symptoms. This is the first study to demonstrate the effectiveness of the combined methods of effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation using mobile app training accompanied by biweekly human mediation in improving swallowing tongue pressure in older adults. The mHealth app is a promising platform that can be used to deliver effective and convenient therapeutic service to vulnerable older adults. To investigate the therapeutic efficacy with a larger sample size and observe the long-term effects of the intervention program, further studies are warranted. International Registered Report Identifier (IRRID) RR2-10.2196/19585

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“…The cost and benefit analysis of online ANC service is also required to assess the feasibility of continuing online ANC service by the decision-making authorities ( 31 ). Of relevance, analysis of mobile health's cost-effectiveness for ANC and facility births showed that mobile health programs were relatively inexpensive and saved lives (for the dollar investment) in Nigeria ( 32 ).…”

Section: Introductionmentioning

confidence: 99%